Job Type
Full-time
Description
Job Purpose
Our Transactional Services division is an integral part of our company's success. The Team is responsible for collecting outstanding insurance balances, appealing denied claims, and resolving A/R for our clients. The successful candidate should have the following: excellent communication skills; excellent critical thinking skills; excellent client relationship skills; thorough understanding of the revenue cycle including third party payer requirements.
Duties and Responsibilities

• Provide assistance/resolution to external and internal client inquiries
• Prepare reports or logs as required
• Act as a technical expert in regards to financial class responsibility, to answer questions raised by clients and team members
• Maintain a current working knowledge of all healthcare related issues and regulations especially Managed Care contracts.
• Responsible to report any detected trends in payments or denials, as well as procedural problems, to the client. Recommendations regarding the correction of these trends and/or problems should also be reported.
• Maintain a professional attitude
• Maintain confidentiality at all times
• Learn and comply with organizational and departmental policies and procedures
• Analyze and solve problems quickly and thoroughly
• Establish realistic goals and priorities concurrent with organizational objectives
• Strong verbal and written skills in order to effectively communicate with patients, co-workers, insurance companies, hospital staff, and clients
• Knowledge of governmental, legal and regulatory provisions related to collection activity
• Knowledge of insurance company practices regarding reimbursement
• Provide support to the Business Development team during the sales process
• Responsible for ensuring that remote client access to is disabled for terminated or transferred employees when applicable in a timely fashion
• Understand and comply with Information Security and HIPAA policies and procedures at all times and ensure all direct reports are trained and in compliance of said policies and procedures at all times.
• Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and enforce such for all direct reports
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties for your respective team
• Report any security or HIPAA violations or concerns for your team to the HIPAA Officers in a timely fashion
• Responsible for ensuring that remote client access to is disabled for terminated or transferred employees when applicable in a timely fashion
• Understand and comply with Information Security and HIPAA policies and procedures at all times and ensure all direct reports are trained and in compliance of said policies and procedures at all times.
• Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and enforce such for all direct reports
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties for your respective team
• Report any security or HIPAA violations or concerns for your team to the HIPAA Officers in a timely fashion

Requirements
Qualifications

• BS in Accounting or Finance, MBA and/or CPA highly desirable
• 10+ years in progressively responsible financial leadership roles, preferably in acute care setting or comparable RCM company
• Analytical and problem solving skills, the ability to understand complex reimbursement structures and the ability to apply contractual and governmental regulations to billing processes
• Team building and cooperative work environment preferred
• Strong interpersonal skills, ability to communicate and manage well at all levels of the organization and with staff at remote locations essential
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results-orientation
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction

Working Conditions

• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.